How to Diagnosis Subacromial Impingement
Before a treatment method can be decided upon, Dr. Boykin will perform a series of examinations and tests in order to properly diagnosis the injury. This will include a detailed history, physical exam, and X-rays. Physical exam tests to assess for impingement include the impingement tests of Neer and Hawkins. In certain cases a MRI scan may be ordered to differentiate between impingement with rotator cuff tendonitis (inflammation of the tendon) or a rotator cuff tear.
First Options for Treating Subacromial Impingement
In cases of subacromial impingement Dr. Boykin usually prefers to attempt non-surgical methods first, as in many cases the injury can be adequately treated without an operation. The pain and inflammation caused by the syndrome can be reduced and possibly even resolve by rest, anti-inflammatory medications, and appropriate physical therapy. In cases with continued pain, an injection of corticosteroids to the subacromial bursa may help alleviate pain and allow the patient to make progress with physical therapy and accomplish longstanding relief. In more serious cases or those that have failed the above mentioned non-operative measures, Dr. Boykin may recommend a surgical treatment.
Surgical Treatment for Subacromial Impingement
In the surgical treatment of nearly all cases of subacromial impingement, Dr. Boykin will perform an arthroscopic surgical approach. This surgery is performed through several very small incisions through which a camera and special surgical instruments are inserted. During this operation the rotator cuff is visualized to make sure there is no tearing. The area of inflammation in the subacromial bursa is then removed. The bone spurs causing the pinching are then also removed and the entire area is smoothed down to allow normal, pain-free motion.
For more information on subacromial impingement, or to discuss your shoulder pain and shoulder injury with Dr. Robert Boykin, please contact his Asheville, Arden, Fletcher and surrounding North Carolina communities, orthopedic practice.